Discovering a lump in your hand can be a source of worry, but most are harmless. While various conditions can cause hand lumps, the majority are benign, meaning non-cancerous. Understanding their common causes and characteristics can help guide appropriate action.
Common Benign Hand Lumps
Ganglion cysts are the most common type of hand lump, frequently appearing near joints or tendons. These fluid-filled sacs can vary in size, sometimes appearing or disappearing, and may be soft or firm to the touch. They arise from tissues surrounding a joint, such as tendon sheaths or joint linings, and contain a thick, gel-like fluid. While often painless, if a ganglion cyst presses on a nerve, it can cause discomfort, tingling, or muscle weakness.
Another common benign growth is a lipoma, a fatty tumor. These lumps are generally soft, movable under the skin, and usually painless. Lipomas are slow-growing and typically do not interfere with hand function unless large or pressing on adjacent structures.
Giant cell tumors of the tendon sheath are the second most common soft tissue tumor in the hand, after ganglion cysts. These are solid masses that grow slowly and are typically firm and nodular. They originate from the synovial lining of tendons and are usually painless, though they can sometimes cause mild sensory disturbances or affect digit function due to their size.
Epidermoid inclusion cysts are slow-growing lumps that form just under the skin. They arise from skin cells trapped beneath the surface, often following a cut or puncture wound. These cells produce keratin, which accumulates to fill the cyst. They are usually firm, round, and often painless.
Less Common or Concerning Causes
Infections, such as abscesses, can cause painful, red, and warm swellings filled with pus, often developing rapidly and sometimes accompanied by fever. These lumps require medical attention for proper treatment, which may include drainage and antibiotics.
Inflammatory conditions can lead to specific types of hand lumps. Rheumatoid nodules are firm lumps that develop under the skin, often near joints affected by rheumatoid arthritis. These nodules are usually not painful unless infected or ulcerated. Gouty tophi are firm, gritty deposits of uric acid crystals in soft tissues, often around joints in the hands. While typically not painful, tophi can become inflamed and tender during gout attacks.
Foreign body granulomas form when the body reacts to a foreign object embedded in the hand, such as a splinter. These lumps are a cluster of immune cells that attempt to wall off the foreign material. They can be painful, swollen, and intermittently inflamed.
Vascular lesions, such as hemangiomas, are lumps composed of blood vessels. These benign tumors can appear as bluish discolorations under the skin, often compressible and sometimes throbbing. They can vary in appearance and may enlarge over time.
Cancerous growths are a rare possibility. These can include soft tissue sarcomas or metastatic lesions that have spread from other parts of the body. Malignant tumors tend to grow quickly and can be irregular in shape. Professional evaluation is important for accurate diagnosis and management.
When to Seek Professional Medical Advice
Seek medical evaluation for any new or changing lump in your hand. Prompt medical attention is warranted if the lump is accompanied by pain or tenderness. A rapid increase in the size of the lump or its sudden appearance should also prompt a visit to a healthcare provider.
Changes in skin color over the lump, such as redness or bruising, along with warmth or fever, are important indicators for medical consultation. If the lump restricts movement of your fingers or wrist, or if you experience numbness, tingling, or weakness in your hand or fingers, professional advice is recommended. Any lump that appears after an injury, or simply causes concern, should be assessed by a doctor.
Diagnosis and General Management Approaches
A doctor typically begins diagnosing a hand lump with a thorough physical examination, inspecting and feeling the lump to assess its size, texture, mobility, and location. The doctor will also ask about your medical history, including when the lump first appeared, any associated symptoms, and relevant past injuries or conditions.
Imaging studies are often used to understand the lump’s internal structure and its relationship to surrounding tissues. X-rays evaluate bones and joints, while ultrasound visualizes fluid-filled structures or assesses soft tissue. Magnetic Resonance Imaging (MRI) provides detailed images of soft tissues and can be particularly useful for identifying the extent of the lump or ruling out bone involvement.
In some cases, a biopsy may be considered to confirm a diagnosis, especially if there is suspicion of malignancy or if imaging results are inconclusive. This procedure involves taking a small tissue sample from the lump for laboratory analysis.
Management approaches for hand lumps vary depending on the diagnosis. For small, asymptomatic benign lumps, observation may be recommended. Fluid-filled cysts, like ganglion cysts, can sometimes be treated with aspiration, where the fluid is drained using a needle. Surgical excision, which involves removing the lump, is an option for symptomatic or persistent lumps. For inflammatory or infectious causes, medication, such as anti-inflammatory drugs or antibiotics, may be prescribed.